Legislative Council Fifty-Second Parliament, Second Session (52-2) 52 2 Parliament of South Australia Legislative Council published Bills Mental Health (Inpatient) Amendment Bill MENTAL HEALTH (INPATIENT) AMENDMENT BILL Second Reading Second Reading Adjourned debate on second reading. (Continued from 4 April 2012.) The Hon. J.M.A. LENSINK Legislative Council The Hon. J.M.A. LENSINK (17:45): I rise to indicate Liberal support for this bill, which is not an extensive bill. It has two major provisions, one being an important change to the language used within the Mental Health Act 2009 to change 'detention' to refer to inpatient treatment and dealing with the regulation of involuntary treatment within treatment centres and confinement issues. The second relates to ECT as it impacts people under the age of 18. In 2009, the parliament did review quite extensively the Mental Health Act 1993 through a bill that was originally tabled in 2008. The review of the Mental Health Act was a very, very important piece of legislation, being many years coming. There were some very significant changes in that, and I am proud of the fact that the Liberal Party introduced some important changes to the original draft, most particularly the introduction of a community visitors scheme and some changes to treatment and care plans being required to be provided by the Guardianship Board, among other things. I will not go through all of that, because it did take us some time and it was very important. I note that a few years after that particular legislation was passed, the government has seen fit to change the way in which leave of absence and detention provisions operate and also the provisions in relation to consent for ECT on minors. I do note that an amendment has been tabled by the Hon. Ann Bressington. The Liberal Party has not had an opportunity to consider that amendment at this stage. I think that the Hon. Rob Brokenshire also indicated on radio that he has amendments, but we are yet to see those. We would prefer not to proceed through the committee stage of this debate until we have had an opportunity to consider those amendments, but I indicate that we will be supporting the overall intent of this legislation. The Hon. A. BRESSINGTON Legislative Council The Hon. A. BRESSINGTON (17:48): I rise to indicate my support for the second reading of the Mental Health (Inpatient) Amendment Bill 2012. The bill seeks to remove some of the stigma of engaging with our mental health system, particularly being the subject of an existing detention and treatment order. It is proposed that these orders be renamed 'inpatient treatment orders', with voluntary patients identified as such, and those who are currently referred to as 'detainees', or being detained, to be known as 'involuntary patients'. As the minister stated when introducing the bill, the new terminology better reflects the reality of mental health facilities, where few involuntary patients are actually securely detained. Most facilities bear no resemblance to a detention facility, despite the image the term 'detention and treatment order' conjures up. Whilst I may not be supportive of some of the bill and our current approach to mental health treatment, I am nonetheless supportive of the change in terminology proposed by the bill for the little it will do to reduce the stigma associated with living with and being treated for a mental health condition. I do indicate to the council, however, my intention to move an amendment to clause 6, which currently provides for the Guardianship Board to overrule the refusal of a parent to consent to their child receiving electroconvulsive therapy (ECT). Whilst the bill provides that a parent or guardian must first be requested to consent to their child under the age of 16 being given ECT, if the parent refuses and the treating psychiatrist insists, the matter can be referred to the Guardianship Board for determination. The Minister for Health, when explaining this cause in another place, stated that it is comparable to the process used when a parent refuses to consent to their child being given a life-saving treatment such as a blood transfusion. Such an example occurred in June 2010, when the Supreme Court overruled the objections of a Jehovah's Witness family. Whilst there are similarities in the process there is, at least to my mind, a significant difference: ECT by any measure is not a life-saving treatment. Members may recall that, when speaking to the Mental Health Bill 2009, I stated my opposition to our approach to mental health, and particularly the use of psychosurgery. It should come as no surprise that this extends to the use of ECT, particularly on minors. Whilst I accept that the use of ECT on minors is rare, the fact is that the Mental Health Act 2009 provides for it as a treatment option. Further, in the Royal Australian and New Zealand College of Psychiatrists' 'Guidelines on the administration of electroconvulsive therapy' there is no impediment to the use of ECT on children, stating that the risk for minors are the same as those for adults. Given that adults received some 6,393 ECT treatments in 2010-11—a simply staggering figure—there is clearly the potential for the number of children undergoing ECT to increase. This is despite significant community opposition to the use of ECT. Some members may recall being bombarded with emails when we were debating the Mental Health Bill (and, unfortunately, many came well after) expressing outrage that children may be required to undergo ECT and other psychiatric treatments without their parents' consent. These concerns are still prevalent. Like me, these people do not consider ECT to be a life-saving treatment worthy of overriding their right to choose their family's treatment options. Similar concerns have been expressed in Western Australia, where a very similar mental health bill is currently being debated. In fact, many are calling for the use of ECT and psychosurgery to be banned on minors under the age of 18. Such calls have found support in the Western Australian Commissioner for Children and Young People, who has recommended such a ban in her submission to the bill's consultation committee, stating, 'I have not seen any compelling evidence or reasonable argument to support its use in relation to children.' Whilst I fully concur with the Commissioner's view, and if I could move an amendment in the alternative I would be asking members to vote on the use of ECT on minors, I am instead proposing to limit the use of ECT to only where a minor's parent consents. My amendment does so by removing the ability to essentially appeal a parent's refusal to allow their child to undergo ECT, with the Guardianship Board only called upon in cases where the parents or guardians are unable to provide consent (for example, due to incapacity). I believe my amendment to meet community expectations of the extent of parental authority, except where of course a life could be saved. As for the minister's statement that 'there is no intention to open the act up for any further amendment at this stage', I would suggest that this is a matter for the majority. It is my hope that a majority of members will support the parental right to say no to their children undergoing ECT and all the trauma, stigma and suffering that that brings about. Debate adjourned on motion of Hon. J.S.L. Dawkins. At 17:54 the council adjourned until Wednesday 2 May 2012 at 14:15.